Emergency order of detention
...t come to the hospital via an ambulance or drives in from the county or other towns then becomes the responsibility of the local agency. Therefore; the agency has to pull manpower from its streets and most of the time pay overtime for the officers to transport the person thirty five mile to a mental health facility. Results The problems of E.O.D will be a continuing problem for small agencies. Large agencies for the most part have special units to handle E.O.D transports. When smaller agencies deal with E.O.D. they have to either pull manpower from who is on duty or call in other officers. This is a strain on budgets by the overtime an average of two to three hours for two officers. Attorneys for the city have agreed with the officers that they have the final say on if a person meets E.O.D criteria and is to be taken into custody and transported. The hospital disagrees saying that the officers should defer to the doctors opinion. There are options that are being considered, one is that if there is a disagreement between the doctor and the officer that a third party mental health facility will be contacted to decide on the transport after hearing the persons history. On transport there is a move by the states legislators that a word change that a designee would transport the person to a mental health facility while still remaining under the officer’s custody. This would allow officers to remain in the city for their duties after the initial assessment is completed. By paying a designee not a law enforcement officer the city would save on overtime costs. Memphis Tennessee developed a Crisis Intervention Team (CIT). The CIT is a police based program with specially trained officers. Following a 1987 police shootout involving a mentally ill person, the police department formed a partnership with the Memphis Chapter of the Alliance for the mentally Ill, the University of Memphis and the University of Tennessee, to develop a specialized unit within the police department to manage community crises, and to intervene with mentally ill people in a safe, effective and processional manner. The mayor requested that this be a collaborative community effort that tapped community resources. The CIT are trained to immediately transport individuals they suspect of having mental illness to the psychiatric emergency service. The program operates on a generalist specialist model, so the CIT officers provide a specialized response to mental disturbance calls in addition to their regularly assigned patrol duties. The officers receive 40 hours of specialized training from mental health providers. I believe that if a department had the manpower and the resources this would be the ideal program. It would provide officers that are interested in helping the mentally ill and would work closely with doctors in the mental health field. There would be no question on who needed to be placed into custody or the transportation issue. However, on August the 1, 2004 District Court Judge John Garner of Pottawatomie County issued a standing court order saying that if a doctor signs a third party affidavit the officer will transport the person to a mental health facility for evaluation. This takes the officer out of any decision or debate at the hospital level but still leaves the officer making the decisions on the street encounters. This decision has mudded the waters for the Shawnee Police Department due to the amount of E.O.D.’s that Pottawatomie County has to respond to monthly. “Over all Pottawatomie county has one of the highest rates of E.O.D. transport through the hospital system than any other County in the state of Oklahoma, We are also not sure if this is due to the lack of understanding on the hospitals part as to what constitutes an emergency and what constitutes an intervention for counsel,” states Chief Conny Clay. In many cases contracting with an individual who is experiencing feels of being overwhelmed but not in total crisis can be placed in contact with a local mental health facility who makes a contract arrangement with the individual to not harm themselves or anyone else and forms a plan for that person and thus avoids both lock down cost as well as court cost for the individual. While the individuals that are in the more crisis stage of a problem can be E.O.D. and receive the needed care that is required in a mental crisis breakdown. According to Chief Clay he states that Judge Garners ruling has forced us to look beyond just up holding the state law but to review cost of the up holding of the statue. While larger agencies have the ability to form task force to deal with the guidelines and assist in a cost effective way to up hold statues the smaller agencies struggle with this issue. The down sizing of our own local police department from the 1980’s to the 1990’s have left us with a big problem when it comes to pulling two officers for a time period of a minimum of two to two and one half hours for a transport to the closest mental health facility. It may not mean much to the general public but when an agency only has six officers to a shift and we have to pull two for transport and on some nights there can be multiple transports then the citizens of the municipality are left with decreased emergency services. When looking at agencies, like Tecumseh, Meeker, and Prague that only staff two officers per shift then those agencies can be in real trouble in both financial transport and staff services. When to the cost of transport has to be taken up by theses agencies then other training programs and equipment must be forgone to cover the stress of transport cost with the salaries and overtime that is incurred. This could easily become a crisis for the city governments. There have been committee meetings regarding the interpretation of this statue and attempts have been made to come to an agreement with the local hospital and police and mental health agencies but at this point to no avail. Each struggle with the concept of cost for transport as well as the interpretation of the law itself have ended in the ruling received from Judge Garner until this can be worked out at the state law level . Until this can be more defined in statue then smaller agencies will continue to struggle with the cost and effects of this problem. Placing more strain on the communities themselves. According to our local Chief of Police Conny Clay the following statues help the definition of the Emergency order of Detention process. Manual for Emergency Detention an Civil Commitment in Oklahoma Title 43, O..S § 205,206 (4)-208 (Oklahoma Department of Mental Health and Substance Abuse 2002) Describes the criteria for taking a subject into custody for mental health, used by Oklahoma Law Enforcement Agencies: 1) Criteria for taking a subject into custody. 2) Who does the evaluation for determining if a subject meets criteria? 3) Transporting the subject for mental health evaluation. 4) What are the responsibilities of the doctors and police? The manual is a summary of describing the duties of law enforcement and the doctors on Emergency Detention Orders and the order and criteria in which a person may be taken into custody for as for an Emergency Order of Detention (E.O.D). The reviewer is critical of the manual because it leaves broad interpretation of responsibility. The manual gives too much authority to the police officer and the decision on if a person meets E.O.D criteria. Unity Healthcare Policy and Procedures Manual (2002) This manual describes the procedures for the local hospital on their criteria for a emergency detention order. This manual gave the doctors the final decision on a person to be placed in emergency detention. This manual states the following. 1) The patient will be examined by the emergency room physician. 2) Appropriate lab will be obtained, if necessary. 3) The mental health facility will be notified for accepting physician and report called to the accepting department. 4) E.O.D papers will be completed. 5) The patient will be transported by a law enforcement agency. 6) The original E.O.D packet is sent with the police officer. 7) A copy of the emergency room chart and E.O.D papers will be sent to the mental health facility via law enforcement. 8) A copy of the E.O.D papers will remain with the original emergency room chart. The reviewer is critical of this policy because it does not provide any solutions if there is a disagreement between the doctor and the police officer if a person meets the criteria for E.O.D, and the procedures it this occurs. Shawnee Police Department Policy and Procedures Manual (2003) This manual describes how a person must be taken into custody and how that person must meet certain criteria before the person is taken into custody and how it is the sole responsibility of the officer to make that determination. The reviewer is critical of this policy because it gives too much power to the officer to make the decisions over a doctor if a person should be taken into custody for an E.O.D. The requirements for taking someone into custody are. 1) A substantial risk of physical harm to oneself as manifested by recent evidence of serious threats of or attempts at suicide or other self-infliction of bodily harm. 2) A substantial risk of physical harm to another person or persons as manifested by evidence of violent behavior directed towards another person or persons. 3) Having placed another person or persons is a reasonable fear of violent behavior directed towards them or serious physical harm to them as manifested by significant serious threats. 4) A reasonable certainty that without immediate treatment, severe impairment or injury will result to the person alleged to be a person requiring treatment. Cushing Regional Hospital Policy and Procedures Manual (2002) Cushing Regional Hospital’s policy states: 1) The individual poses an imminent danger to either himself/herself or others. 2) The person is considered in need of mental treatment. 3) The person is refusing treatment. Cushing Hospital’s procedures are: 1) To gain an Emergency Order of Detention, the local law enforcement must be summoned in order to place the person in prote...